Professional Personal Advocates

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Denver, CO -- If you’re inviting people over who have refugee status, you’d better have tea and an atlas.  A few years ago, my friend Sara and I hosted a dinner for several of the community navigators who help run our local Elder Refugee Program.  The navigators serve as liaisons to older adults with refugee status and their experience comes from navigating the US as a new country themselves.  The U.S. is at least the third country an elder has had to call home.

As we poured over the atlas, the navigators showed me where they had lived.  One navigator talked about her hometown in Burma, then the route she fled to Thailand (Country #2).  Because she couldn’t stay in Burma or Thailand, her paperwork eventually went through to move her permanently to the United States (Country #3).  Her third country and our third pot of tea.

My favorite story about this particular woman was from a time when funding for refugee programming was in crisis.  Sara was worried: What if this? What if that happens?  In response, the woman shook her head and said, “Oh Sara, we can’t predict the future!”  

As it turns out, we are not very good at predicting the future, especially when it comes to knowing what will make us happy.  As much as we guess, worry, and agonize over decisions, when it comes down to it, we really can’t predict how a decision is going to make us feel.  

When podcast host Shankar Vedantam of Hidden Brain interviewed Daniel Gilbert, a Harvard professor of psychology, he explained his research showing that our predicting what will make us happy is often about as accurate as forecasting the weather.  

Predicting how a particular decision will make us feel is known as affective forecasting.  Gilbert references one particularly tough year in his life.  He admits that, if someone had asked him a year earlier how he’d get through it, he would’ve said he expected the year to be utterly devastating.  Yet, when he looked back a year later, it wasn’t as bad as he thought it would be. What we experience feels different after we experience it than what we would’ve imagined it to feel beforehand.  

So why are decisions so painful?  For the simple reason that we haven’t made them yet.  Leading up to tough decisions, the alternatives -- either this or that -- seem so incredibly close.  Gilbert points out that, after we make a decision, our brains then set to work convincing us that our “now” is better than what we left behind.  Our mind, finds “realistic ways to see the world so that it feels better about the world in which it finds itself”.  

Some of the hardest decisions are who to pick as agents on our power of attorney (POA) forms.  With both the Medical Durable Power of Attorney (or MDPOA) and the Financial Power of Attorney forms, you designate agents who can make decisions for you if you become unable to do so yourself.  The person who acts as your Power of Attorney should the need arise cannot overrule your preferences.  It’s no wonder forecasting these situations feels like a lot of big “ifs”.

Several other factors come into play as well and often people don’t complete their forms because:

a.) we don’t want to think about something bad happening to us;

b.) we don’t want to think about putting someone in the place of having to make a hard decision for us.

Today I led a support group where one gentleman asked, “What if you’re afraid that they won’t listen to you when you say I don’t want to go to the hospital….even if you know you could croak?”  Good question.

Maybe it’s less about choosing what you do and don’t want, and more about having the paperwork in place so you don’t have to think about it again.  Our minds are creative when it comes to anticipating every single what if question that could be made but -- as studies on affective forecasting note -- we can’t predict our experience or the future.  

So back to POA forms.  What if you gave people a sense of what you want your care to look like and a legal document to support them?  What if you knew you could change it at any time? (you can, by the way.) We’re terrible at predicting the future -- we can’t predict how it could feel to be incapacitated or how another person will feel making tough decisions for us.  However, we can trust that once decisions are made, we will feel relief.

Finally, uncertainty amplifies emotions.  Happy and unhappy surprises make a bigger impact on us than things we know will be happy and unhappy.  Putting things in place to limit the unhappy surprises can minimize the long-term impact of those events.  

On that note, some people I know are designating a professional to offer guidance to their POA agents should the need arise.  A professional personal advocate. These advocates know the systems and benefits in the field of aging and are trained to help families make their best decisions.  A professional personal advocate is someone who can support your POA agent by offering education, support and options so they can make the best decision for your well-being.  And they are free to designate -- you only pay them once you use them.

In the event that you experience an event that causes another person to have to choose your care, a professional personal advocate is invaluable for your agent to consult.  They can be a private geriatric social worker, an aging services consultant, or a care manager. Pick someone with connections, experience and a curiosity to keep learning. They can know a lot about things like Medicare or end-of-life care but they should be a professional whom, first and foremost, you trust.  By choosing a professional personal advocate, you are setting yourself up for success as well as the person who has to make decisions on your behalf.

Completing Power of Attorney forms is hard and it is one way to limit surprises.  May is National Elder Law Month. Some of the POA forms (the medical ones) you can fill out on your own (Click here for Colorado's form).  Others (the financial ones) should be completed by an elder law attorney if there are resources and assets. If you need a recommendation for an attorney, maybe it’s time to call an professional in the field of aging for a referral.  And while you’re at it, consider asking them to be your professional personal advocate.

Western Care Partners is proud to serve as designated professional personal advocates for those wanting to put an added layer of support in place for their loved ones.  We provide a simple form for individuals and families to use in appointing someone to this role -- please contact us for more information.

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